Travel health - yellow fever immunisation

Summary

Yellow fever is a viral disease spread by mosquitoes – so travellers should always protect themselves against mosquito bites.

Yellow fever can be fatal.

Immunisation reduces the risk of infection with yellow fever.

Some countries require travellers to have an International Certificate of Vaccination or Prophylaxis to prove that they have had the yellow fever vaccine.

Yellow fever vaccine is safe and effective for life for most situations.

Find out if the countries you intend to visit have requirements for yellow fever vaccination. You must have the vaccine at least 10 days before travelling.

Yellow fever is a serious viral disease, transmitted by mosquitoes, found in parts of Africa and Central and South America. The World Health Organization (WHO) keeps updated lists of countries where yellow fever is widespread. The name of this disease comes from the fact that people with serious infections have yellow skin and eyes (jaundice) caused by infection of the liver.

Vaccination for yellow fever is generally safe and effective, and reduces the risk of yellow fever infection. Some countries require that people travelling through infected areas show proof of vaccination against yellow fever with an International Certificate of Vaccination or Prophylaxis. Vaccination and certification is available through travel clinics or health providers authorised by WHO. You should always avoid mosquito bites to reduce the risk of all mosquito-borne diseases.

Fatal cases of yellow fever in unvaccinated travellers to Africa and South America continue to be reported.

Symptoms of yellow fever

The first symptoms of yellow fever appear three to six days after exposure to the virus. These symptoms are known as stage one of the disease and include:

These symptoms last for three to four days and then settle over one to two days. In mild cases, the infection ends after stage one as the virus is cleared. But in severe cases of yellow fever, this remission period is followed by serious symptoms and complications known as stage two.

Complications of yellow fever

In 15 to 25 per cent of cases of yellow fever, severe symptoms develop, even if there has been a remission period. This is known as stage two and occurs because the yellow fever virus has the ability to infect organs such as the liver, heart and kidneys. This is also known as the ‘toxic’ stage of the infection and about half of the people who reach this stage will die.

The severe complications include:

high fever

pain in the upper part of the abdomen

vomiting – black, ‘coffee-ground’ vomit

bleeding

jaundice (yellow skin and eyes)

kidney failure

liver failure

death.

Immunisation against yellow fever

If you are travelling or passing through areas infected with yellow fever, some countries require you to be vaccinated. A record of your immunisation must be entered and validated in your International Certificate of Vaccination or Prophylaxis by a healthcare provider that is authorised by the WHO to vaccinate against yellow fever.

Although some countries have no entry requirements, others may require proof of vaccination for all travellers in order to satisfy entry requirements. You can find out if the countries you intend to visit have requirements for yellow fever vaccination by checking the Department of Foreign Affairs and Trade's Smartraveller website, or asking your GP (doctor) when you have your appointment.

It is best to arrange an appointment with your GP or a travel clinic doctor six to eight weeks prior to departure in case a series of vaccines are needed. Yellow fever vaccine should be given at least 10 days before entering a country where immunisation is a legal requirement in order to avoid quarantine procedures.

Immunisation against yellow fever only requires a single dose of vaccine, which usually gives most people lifetime immunity. Also, in most cases, once you have been vaccinated, the certificate is valid for life.

People who should receive yellow fever vaccination

People who should be vaccinated for yellow fever include:

people over nine months of age travelling to or living in areas with a high risk of yellow fever transmission

people who work in laboratories and routinely work with yellow fever virus.

People who should not receive yellow fever vaccination

The vaccine is not suitable for everyone and should not be given to people who:

are under nine months of age

have had a severe allergic reaction (anaphylaxis) to an earlier dose of the vaccine

have had severe allergic reaction (anaphylaxis) to any component of the vaccine

have a history of a thymic disorder – including myasthenia gravis, thymoma, thymectomy, DiGeorge syndrome, or cases of damage to the thymus from chemotherapy, radiotherapy or as a result of complications after transplantation.

Pregnancy and yellow fever immunisation

Immunisation against yellow fever is not usually recommended for women who are pregnant or breastfeeding babies under nine months of age. Speak with your doctor if you are pregnant and unable to avoid travel to an area where yellow fever is widespread.

Many vaccine injections may result in soreness, redness, itching, swelling or a burning sensation at the injection site for one to two days. Paracetamol might be required to ease the discomfort.

There are a number of treatment options that can reduce the side effects of the vaccine, including:

giving extra fluids to drink and not overdressing if there is a fever

although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).

Concerns about side effects

If a reaction following immunisation is unexpected, persistent or severe, or if you are worried, see your GP (doctor) or immunisation provider as soon as possible ,or go directly to a hospital.

You can discuss with your immunisation provider how to report adverse events in other states or territories. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.

Rare side effects

There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.

Two very rare side effects associated with the yellow fever vaccine are inflammation of the brain (meningoencephalitis) and organ failure (viscerotropic disease). People over 60 years of age are at a small risk of these rare side effects, and people with thymus disorders are at increased risk of viscerotropic disease.

Immunisation and HALO

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.

No Jab No Play – from 1 January 2016, all parents/guardians seeking to enrol their child at an early childhood service in Victoria must provide evidence that the child is fully immunised for their age...

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This page has been produced in consultation with and approved by:
Travel Clinics Australia

Last updated:
November 2018

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